RESUMO
Background: Inflammation plays a central role in atherogenesis. The major neutrophilic peptide alpha-defensin is a promising evolving risk factor for atherosclerosis. The aim of the present study was to examine the role of alpha-defensin in predicting future major adverse cardiovascular events (MACE) occurrence in fully revascularized patients with stable CAD under optimal medical therapy. Methods and results: We retrospectively examined the prognostic value of baseline plasma alpha-defensin levels in predicting MACE occurrence in 174 fully revascularized patients for stable CAD between March 2016 and January 2017. Alpha-defensin levels were found 20 % higher among demised patients (10,859 pg/ml, IQR [6,920 to 23,320] vs. 9,020 pg/ml, IQR [5,540 to 16,180] pg/ml, P = 0.15). The absolute increase in mortality risk in patients with alpha-defensin levels greater than the median values was 72.5 % (P = 0.33). Log-rank analysis proved both recurrent PCI for de novo lesions (14.9 % and 2.3 %) and the composite of mortality and recurrent PCI for de novo lesions (27.6 % vs. 9.2 %) were significantly related to alpha-defensin values greater than the median (>9200 pg/ml). Conclusion: Baseline plasma alpha-defensin is an independent predictor of mortality and recurrent PCI among patients with stable CAD. Alpha-defensin may evolve as a promising factor in cardiovascular risk assessment beyond traditional risk factors. Targeting alpha-defensin to ameliorate MACE occurrence should be addressed in future studies.
RESUMO
The adherence to follow-up testing instructions post-hospitalization is influenced by a variety of factors. Our aim was to assess the parental adherence to follow-up instructions and identify the factors that influence it. Parents of 200 children were asked about their adherence with these instructions; responses were obtained from 184 of 200. Parents did not adhere in 20 of 194 (10.9%) of cases. Families of infants under 12 months and children older than 10 years had lower adherence rates. Test completion was more frequent for children discharged with a test appointment compared with those discharged without an appointment (96% vs 86.6%; P = .07). The main reasons for non-adherence were disagreement as to the value of the testing (45%) or parental misunderstanding (30%). In conclusion, in order to increase adherence with post-hospitalization follow-up testing, physicians should focus on explaining the need and importance of the test and schedule an appointment prior to discharge.